Postoperative Intensive Care Unit Admissions in Cameroon: Indications, Outcomes, and Predictors of Mortality at Douala General Hospital

Abstract

Background: Postoperative complications are a major cause of morbidity and mortality worldwide, particularly in low-resource settings. Admission to intensive care units (ICUs) after surgery plays a critical role in preventing and managing life-threatening complications. However, data from sub-Saharan Africa remain scarce. Objective: To determine the indications, outcomes, and predictors of mortality among postoperative patients admitted to the ICU of Douala General Hospital, Cameroon. Methods: We conducted a retrospective cross-sectional study of all patients admitted to the ICU after surgery between January 2018 and December 2022. Sociodemographic, clinical, surgical, and outcome variables were extracted from medical records. Data were analyzed using SPSS v25. Logistic regression identified predictors of mortality, with significance set at p Results: A total of 352 patients were included. The mean age was 46.3 ± 18.4 years, with a male predominance (56.2%). Emergency surgeries accounted for 61.6% of admissions. The most common indications for ICU admission were hemodynamic instability (27.6%), severe sepsis/septic shock (21.3%), and respiratory failure (19.2%). The mean length of ICU stay was 6.8 ± 4.2 days. Postoperative complications included sepsis (29.5%), acute respiratory distress syndrome (15.6%), and acute kidney injury (10.2%). The overall mortality rate was 28.4%. Independent predictors of mortality were septic shock (OR: 3.2, 95% CI: 1.8 - 5.7), need for mechanical ventilation (OR: 2.9, 95% CI: 1.6 - 5.1), and emergency surgery (OR: 2.4, 95% CI: 1.3 - 4.2). Conclusion: Postoperative ICU admissions at Douala General Hospital are frequent and associated with high mortality, primarily driven by sepsis and respiratory failure. Strengthening perioperative care, infection prevention, and timely ICU referral are critical to improving surgical outcomes in Cameroon.